Asymptomatic lower extremity deep venous thrombosis resulting in fibula free flap failure.

OBJECTIVES/HYPOTHESIS: The successful harvest and transplant of a fibular flap depends on many factors, including healthy inflow and outflow systems. A contraindication to harvesting a fibular flap is disease of the lower extremity arterial system; therefore, preoperative evaluation of the arterial system is routine. Preoperative evaluation of the venous system is not routine, unless there is clinical suspicion of venous disease.

METHODS

Retrospective chart review.

RESULTS

Two cases of occult deep venous thrombosis (DVT) were encountered intraoperatively resulting in nontransplantable flaps.

CONCLUSIONS

This finding represents a serious concern, and we believe that venous imaging should be considered in patients with significant risk factors for harboring an occult DVT. Laryngoscope, 2009.